Death by a Thousand Cuts: Vaccines, Non-Profits, and the Dissemination of Medical Information

The vaccine debate and prying into Planned Parenthood’s Standard Operating Procedure are two arenas I have not gravitated toward. Genetically engineered crops, industrial farming, confined animal feeding operations (CAFOs), dams killing wild salmon, these are my fortes. The news daily is like death by a thousand cuts for me tied to new studies on collapsing ecosystems, indigenous people fighting against mines and other extractive industries, and more and more on climate change.

My story started when I was in a Planned Parenthood training, a mandatory course for social workers titled Fundamentals of Sex Ed. For a total of possibly 30 seconds out of a 16-hour two-day training (I was kicked out after day one), I voiced my opinion about the potential risks associated with Gardasil. On a slip of paper, then, in an anonymous forum, I went further with about 60 words answering this first day evaluation question: What could Planned Parenthood have done differently today in the training?

I am really disappointed that Planned Parenthood in Seattle is so lock-step in line with Big Pharma. Especially in the case of Gardasil, which is a vaccine that has gotten tens of thousands complaints about it. Anyone, including my 16 to 21 year old clients, could easily Google ‘Gardasil Dangers’ and find a plethora of very disturbing and legitimate information about its dangers. I wish Planned Parenthood showed more critical thinking and independent pedagogical standards, including informed consent.

Less than two hours after the training, I was called at my hotel room by my supervisor, who let me know:

The Planned Parenthood trainers said they do not want you back for the second day of training. I am putting you on administrative leave. I am looking into what happened in Seattle. Do not return to the office until further notice.

The Sordid History of the HPV Vaccine Marketing

I have collected a hundred reports, articles, documentaries and blogs tied to the HPV vaccine, which has been in use since 2006. The treasure trove is enlightening, intimidating, depressing and validating. Every drug and chemical in the world should have this amount of scrutiny, preferably before it is released, and yet, the depressing part is that these chemicals get very little advance review and once introduced into our systems of medicine, food production/ processing, and modern industrial existence, the unintended consequences and synergistic downsides are more difficult to elevate to a level of grave public concern. Indeed, it often takes 20 years before the FDA will take action and the lessons of our folly reaches clinical care. Why so long? Perhaps it has to do the intense marketing of these chemicals.

The PR firms, legal teams, government agencies, law makers, and politicians all have a stake in the game with billions of dollars in profits at stake. In fact, the pharmaceutical industry is the single largest contributor to congressional accounts in the United States, spending almost 4 billion dollars annually in lobbying efforts, more than double the spending of the defense industry. This is, of course, in addition to the many millions more spent on marketing their products. The issues whirling around Gardasil represent a microcosm of all that is wrong with our healthcare industry. It is difficult at best and impossible for most to speak out against the power purchased with these multi-million dollar budgets. For citizens, consumer groups, watchdog agencies or journalists going against the grain, the road to hell is paved with threats, lawsuits, and vitriol. We are labeled conspiracists, Luddites, anti-science extremists and crazies or nuts.

Fact is Stranger than Fiction

What I am finding in my own nascent life tied to Gardasil and Planned Parenthood is a type of bearing witness, knowing there are deeper and more layered and nuanced ways of looking at the mad men in advertising, marketing, propaganda and more existential ways of contemplating the insanity of unlimited growth, the consumer assault and battery from the merchants of death. Decades ago, Rachel Carson wrote:

The crusade to create a chemically sterile, insect-free world seems to have engendered a fanatic zeal on the part of many specialists and most of the so-called control agencies.

She believed that she was living in an era

…dominated by industry, in which the right to make a dollar at whatever cost is seldom challenged. When the public protests, confronted with some obvious evidence of damaging results of pesticide applications, it is fed little tranquilizing pills of half-truth. We urgently need an end to these false assurances, to the sugar coating of unpalatable facts.

The cross-pollination of a huge marketing campaigns with scientists and medical companies and pharmaceuticals is both bizarre and business as usual. Here, in 2006, from one of those marketing firms:

More than 95 insurance plans–covering 94 percent of insured individuals–have decided to reimburse Gardasil, according to Merck. The Centers for Disease Control and Prevention has also added the vaccine to its Vaccines for Children Contract, making it available to Medicaid-eligible, uninsured, under-insured, or Native American children up to the age of 18.

Analysts are optimistic about the vaccine’s market potential. “It’s very clear that patients are going to be interested in it,” said John Lebbos, MD, therapeutic area director of infectious diseases at market research firm Decision Resources. “From what I’ve seen, it’s going to be a blockbuster.”

Education about the vaccine is going to be a critical piece–due both to a lack of understanding about HPV as well as early controversy that vaccination might lead to teen promiscuity.

Note the terminology of the purveyors of capital and profit-making health care: “vaccine’s market potential” and “it’s going to be a blockbuster.” These are the sentiments of a physician whose Hippocratic oath states first do no harm. More importantly, these are the sentiments that drive our healthcare industry. It is profit driven, not necessarily health driven, and therein lay one the many problems associated with the promotion of medications, vaccines, and/or environmental chemicals; profits and health need not align.

The PR genius behind all stages of Merck’s HPV and Gardasil campaigns is the PR giant Edelman. The world’s largest independent PR firm, Edelman boasts more than 2,100 employees working in 46 wholly owned offices worldwide, plus the additional resources of more than 50 affiliates. Apparently Merck is hoping that most, if not all the states in the US, will mandate a vaccine against HPV as a pre-requisite for school attendance. And beat rivals to it, before GlaxoSmithKline gets FDA approval for its Cervarix.

But, 11 years ago, even before FDA approval, Merck and Edelman were on the PR war-path beating the cervical cancer drums:

Merck used its deep pockets to make sure that even before the FDA had approved Gardasil, there was a growing awareness of and concern about HPV and its link to cervical cancer. According to Bloomberg News, Merck spent $841,000 for Internet ads alone relating to HPV in the first quarter of 2006 — months before the FDA had even approved Gardasil (Part One: Setting the Stage).

Drug Marketing through Non-Profit Support and Favorable Legislation

How does this marketing affect the non-profit sector? A report in the New England Journal of Medicine found that “83 percent of the nation’s 104 largest patient advocacy groups take contributions from the drug, medical device and biotech industries,” and “one-fifth of the patient advocacy groups studied accepted $1 million or more from drugmakers, but exactly how much those groups accepted is fuzzy.” It is fuzzy because non-profit funding streams are not disclosed and/or are purposefully channeled through pharma subsidiaries in order to obfuscate obvious connections. If the organization’s existence depends upon funding from a product manufacturer, is it unreasonable to assume that the organization might be beholden to the views of their funders? I don’t think so. Check out the interview with one of the world’s richest men’s son, Peter Buffet, on the Charitable Industrial Complex here: My talk with Peter Buffett ,Warren Buffett’s son, about what’s wrong with philanthropy.

Here’s just one example of non-profit collusion with the pharmaceutical companies and health care for-profits. This is a three-part series written for PR Watch in 2017 by journalist Judith Siers-Poisson:

According to their website, “Women in Government is a national 501(c)(3), non-profit, bi-partisan organization of women state legislators providing leadership opportunities, networking, expert forums, and educational resources to address and resolve complex public policy issues.” The campaigns that they feature on their home page deal with kidney health, Medicare preventive services, higher education policy, and the “Challenge to Eliminate Cervical Cancer,” which was publicly launched in 2004.

On February 2, 2007, Texas Governor Rick Perry, against the wishes of his conservative base and to the surprise of critics, signed an executive order mandating HPV vaccination for girls entering seventh grade. Then, unfortunately for Perry and Merck, details of his many connections with both Merck and Women in Government became public.

Ellen Goodman of the Boston Globe noted, “It turned out that Perry’s former chief of staff is now a lobbyist for Merck. Did that look bad? Whoa, Nellie. Did it look bad that Merck had funded an organization of women legislators backing similar bills? Whoa, Merck.” USA Today reported that Perry’s current chief of staff’s mother-in-law, Texas Republican State Representative Dianne White Delisi, is a state director for Women in Government. Perry’s wife, Anita, a nurse by training, addressed a WIG summit on cervical cancer in Atlanta in November 2005. Perry also received $6,000 from Merck’s political action committee during his re-election campaign.

In 2004, more than 20 WIG funders were pharmaceutical companies or entities heavily invested in health care issues that could come before state legislators. A short list includes both Merck & Co., Inc and Merck Vaccine, GlaxoSmithKline (which will soon have the second HPV vaccine on the market), and Digene Corporation (which manufactures an HPV test). Other drug interests listed as donors to WIG include Novartis, Eli Lilly, AstraZeneca, Bayer Healthcare, Pfizer, Bristol-Myers Squibb (both the company and their foundation), and Pharmaceutical Research and Manufacturers of America, also known as PhRMA, one of the largest and most influential lobbying organizations in Washington representing 48 drug companies.

The funders of Women in Government today, as I am looking at their website, are still those big ones listed above and others in the for-profit health care fields.

So here the pharmaceutical companies funded a non-profit organization that then supported legislators and legislation favorable for the companies and products. By all accounts, a common practice. What happens when they also fund the organizations tasked with providing healthcare, organizations such as Planned Parenthood? Can we tie Planned Parenthood to the makers of Gardasil? I think we can. Here is just an introduction to their funding.

According to a Washington Post article run in August 2015, during the fiscal year that ended June 30, 2014, Planned Parenthood affiliates around the country received $528.4 million in government funds (a combination of state, federal and sometimes local government dollars). Those federal dollars were the single largest source of money coming into the organization and its local affiliates, by far. Another $305.3 million came from non-government sources, about $257.4 million reached the organization after private donors and foundations made contributions and bequests. The organization also raised another $54.7 million in fees charged for its services. Government funding, with federal dollars comprising the biggest portion of this part of the organization’s budget, are absolutely critical to Planned Parenthood’s total operation, but so too are the private funds. How and from whom those private funds come aligns quite clearly with the organization’s view on certain drugs and vaccines. On the surface, this seems perfectly reasonable. Why wouldn’t a private foundation support an organization that aligns with its goals? It would be illogical to support an organization with contrary views. What becomes clear though, once we begin to unravel these connections, is just how deeply entrenched these alliances are. It begs the question, if a significant portion of one’s operational budget comes from a foundation and/or a manufacturer who supports a particular product or set of products, is it possible to question those products in any meaningful way or at all? Probably not.

Just recently, Peter Doshi, associate editor of the British Medical Journal, published a scathing report about the specious relationships between vaccine educators like Every Child by Two, the Immunization Action Coalition and even the American Academy Pediatrics, the CDC and the pharmaceutical industry. Each organization received millions of dollars in funding both directly from the CDC and from industry, and as a consequence, their recommendations regarding vaccines are in lockstep with their funders. When pressed about these relationships and whether any of the organizations had ever questioned the safety or efficacy of the products they recommend, each admitted that they had not.

So just how independent and reliable is the health information put forth both non-profit organizations like Planned Parenthood, who receive their funding from industry or foundations supported by industry? Moreover, how closely must the organization’s employees adhere to the accepted party line? If my case is any indication, pretty damned closely.

Stay tuned for part three in this series, where I’ll detail the complicated and compromising funding sources of Planned Parenthood and its affiliates.

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Paul has been writing in a journalistic way since 1974. He's covered the environment and all daily newspaper beats since that time. He has worked in Mexico, Guatemala, Belize and Vietnam on environmental justice stories. He has a master's in English and a graduate degree in urban and regional planning. Additionally, he writes regularly for Dissident Voice, LA Progressive and other venues. He is a member of the Society for Professional Journalists for which he has won a few writing awards. He lives and works in the Pacific Northwest-Portland. His teaching career has taken him to Texas, Juarez, New Mexico, Washington, Oregon, and Vietnam.